Ganciclovir: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
*[[CMV]] prophylaxis, solid organ transplant | *[[CMV]] prophylaxis, solid organ transplant | ||
**IV route: 5mg/kg IV q12h x7-14 days, then 5mg/kg IV q24h or | **IV route: 5mg/kg IV q12h x7-14 days, then 5mg/kg IV q24h or 6mg/kg IV 5x/wk | ||
**PO route: 1000 mg PO tid, give with food | **PO route: 1000 mg PO tid, give with food | ||
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*[[CMV]] retinitis, immunocompromised patients | *[[CMV]] retinitis, immunocompromised patients | ||
**Induction treatment: 5mg/kg IV q12h x14-21 days; Info: not 1st-line agent | **Induction treatment: 5mg/kg IV q12h x14-21 days; Info: not 1st-line agent | ||
**Maintenance treatment, IV route: 5mg/kg IV 5-7x/wk; Alt: | **Maintenance treatment, IV route: 5mg/kg IV 5-7x/wk; Alt: 6mg/kg IV 5x/wk; Info: not 1st-line agent | ||
**Maintenance treatment, PO route: 1000 mg PO tid; Alt: 500 mg PO q3h while awake (6 doses/day); Info: not 1st-line agent; give with food | **Maintenance treatment, PO route: 1000 mg PO tid; Alt: 500 mg PO q3h while awake (6 doses/day); Info: not 1st-line agent; give with food | ||
| Line 23: | Line 23: | ||
*[[CMV]] prophylaxis, solid organ transplant | *[[CMV]] prophylaxis, solid organ transplant | ||
**Induction: 5mg/kg IV q12h x7-14 days | **Induction: 5mg/kg IV q12h x7-14 days | ||
**Maintenance: 5mg/kg IV q24h; Alt: | **Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk | ||
*[[CMV]] prophylaxis, HIV-assoc | *[[CMV]] prophylaxis, HIV-assoc | ||
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*[[CMV]] infection | *[[CMV]] infection | ||
**Induction: 5mg/kg IV q12h x14-21 days; Info: may increase dose to 7.5mg/kg IV q12h | **Induction: 5mg/kg IV q12h x14-21 days; Info: may increase dose to 7.5mg/kg IV q12h | ||
**Maintenance: 5mg/kg IV q24h; Alt: | **Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk | ||
*[[CMV]] infection, congenital (<1 mo) | *[[CMV]] infection, congenital (<1 mo) | ||
** | **6mg/kg IV q12h x6wk | ||
==Special Populations== | ==Special Populations== | ||
Revision as of 01:09, 20 July 2016
Administration
- Type: Antiviral
- Routes of Administration: IV, PO
- Common Trade Names: Cytovene
Adult Dosing
- CMV prophylaxis, solid organ transplant
- IV route: 5mg/kg IV q12h x7-14 days, then 5mg/kg IV q24h or 6mg/kg IV 5x/wk
- PO route: 1000 mg PO tid, give with food
- CMV prophylaxis, HIV-assoc.
- IV route: 5mg/kg IV 5-7x/wk; Info: not 1st-line agent
- PO route: 1000 mg PO tid; Info: not 1st-line agent; give with food
- CMV retinitis, immunocompromised patients
- Induction treatment: 5mg/kg IV q12h x14-21 days; Info: not 1st-line agent
- Maintenance treatment, IV route: 5mg/kg IV 5-7x/wk; Alt: 6mg/kg IV 5x/wk; Info: not 1st-line agent
- Maintenance treatment, PO route: 1000 mg PO tid; Alt: 500 mg PO q3h while awake (6 doses/day); Info: not 1st-line agent; give with food
Pediatric Dosing
Off label use as pediatric medication
- CMV prophylaxis, solid organ transplant
- Induction: 5mg/kg IV q12h x7-14 days
- Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk
- CMV prophylaxis, HIV-assoc
- 5mg/kg IV q24h
- CMV infection
- Induction: 5mg/kg IV q12h x14-21 days; Info: may increase dose to 7.5mg/kg IV q12h
- Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk
- CMV infection, congenital (<1 mo)
- 6mg/kg IV q12h x6wk
Special Populations
Renal Dosing
- IV route, induction treatment: CrCl 50-69: 2.5mg/kg q12h; CrCl 25-49: 2.5mg/kg q24h; CrCl 10-24: 1.25mg/kg q24h; CrCl <10: 1.25mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- IV route, maintenance treatment: CrCl 50-69: 2.5mg/kg q24h; CrCl 25-49: 1.25mg/kg q24h; CrCl 10-24: 0.625mg/kg q24h; CrCl <10: 0.625mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- PO route: CrCl 50-69: 1500 mg/day divided qd-tid; CrCl 25-49: 1000 mg/day divided qd-bid; CrCl 10-24: 500 mg qd; CrCl <10: 500 mg 3x/wk; HD: give dose after dialysis, no supplement
Contraindications
- Allergy to class/drug
- hypersens. to acyclovir
- ANC <500
- Plt <25,000
Adverse Reactions
Serious
- thrombocytopenia
- neutropenia
- pancytopenia
- sepsis
- nephrotoxicity
- seizures
- retinal detachment
- HTN
- pancreatitis
Common
Pharmacology
- Half-life: 3hr
- Metabolism: CYP450
- Excretion: Urine
Mechanism of Action
Inhibits DNA polymerase and incorporates into viral DNA
Comments
See Also
References
Epocrates, UpToDate